An independent inquiry into the junior doctors' recruitment 'crisis' has called for a national committee to scrutinise strategic health authorities' workforce planning.
Launching its interim report on Modernising Medical Careers, the inquiry's chair, Sir John Tooke, said the failures of the Medical Training Application Service this year had been a 'sorry episode' and called for 'radical changes'.
MTAS was the online system launched this year for matching junior doctors to specialist training posts, but was scrapped after critics said it left thousands of excellent candidates without jobs.
The report, Aspiring to Excellence, is deeply critical of Department of Health policy-making behind MMC, which it says led to a 'very weak governance and risk-management process'.
It questions the decision to devolve workforce planning to SHAs - but says removing responsibility for this after only 18 months would be too disruptive. Instead, the report recommends regional workforce plans be overseen and scrutinised by a national committee with service, professional and employer representation. SHA chief executives should be personally accountable for building relationships with local education providers. It suggests doing this should be among their annual appraisal targets.
The report says: 'The inquiry remains to be convinced that distributing the majority of workforce planning function and the training commissioning function to SHAs will necessarily guarantee a better outcome and national consistency.'
Workforce planning weaknesses were highlighted in January, when HSJ revealed a leaked workforce strategy document had showed there would be a shortage of 1,000 junior and staff-grade doctors and a glut of 3,200 consultants by 2011.
The report says the DoH should appoint a suitably qualified person at director level to lead medical education policy and work with the medical profession.
It recommends the merger of two training regulators - the General Medical Council and Postgraduate Medical Education and Training Board.
Sir John also warned against an 'open door' policy for immigrant doctors when UK graduates are costing up to£250,000 to train.
He suggested guaranteeing a postgraduate training place to all those at UK medical schools.
But he refused to allocate blame for the loss of confidence in MMC: 'The inquiry wasn't set up to name, blame and shame,' he said.
The DoH has already said it will not be using a computerised system for next year's round of recruitment and will stagger junior doctors' starting dates.
Health minister Ben Bradshaw said the government had learned important lessons from the process and would consider the report fully.
British Medical Association council chairman Dr Hamish Meldrum said: 'The report highlights the importance of doctors being involved in the management of the health service.'
NHS Employers deputy director Sian Thomas also welcomed the report, which she said reflected the views of employers in the NHS on the changes required.